Bowel Preparation Prostate Radiation Therapy

Skin And Hair Reactions

During treatment, you probably wont notice any changes in your skin in the area being treated. However, you may lose some or all of the hair in your pubic area. The hair will usually grow back 3 to 6 months after treatment is done however, the color and texture may be different.

Below are guidelines to help you care for your skin during treatment. These guidelines refer only to the skin in the area being treated with radiation.

Keep your skin clean

• Bathe or shower daily using warm water and a mild unscented soap, such as Neutrogena®, Dove®, baby soap, Basis®, or Cetaphil®. Rinse your skin well and pat it dry with a soft towel.
• When washing, be gentle with your skin in the area being treated. Dont use a washcloth, a scrubbing cloth, or brush.
• If you received tattoo marks before your treatment, they are permanent and wont wash off. You may get other markings during treatment such as an outline of your treatment area with a purple felt-tipped marker. You can remove these markings with mineral oil when your therapists say its okay.
• Dont use alcohol or alcohol pads on your skin in the area being treated. Also, dont use astringents, which are substances that shrink your body tissues. Two examples of astringents are calamine lotion and witch hazel.

Moisturize your skin often

Avoid irritating the skin in the area being treated

Stereotactic Body Radiation Therapy

This technique uses advanced image guided techniques to deliver large doses of radiation to a precise area, such as the prostate. Because there are large doses of radiation in each dose, the entire course of treatment is given over just a few days.

SBRT is often known by the names of the machines that deliver the radiation, such as Gamma Knife, X-Knife, CyberKnife, and Clinac.

The main advantage of SBRT over IMRT is that the treatment takes less time . The side effects, though, are not better. In fact, some research has shown that some side effects might actually be worse with SBRT than with IMRT.

General Advice And Support Services

Most of your questions should have been answered by this leaflet. If you have any further questions please ask any member of the healthcare team caring for you.

Female patients aged between 12 and 55 years of age will be asked if they are or might be pregnant. If at any point during your radiotherapy treatment you suspect that you may possibly be pregnant, you must inform your treatment team immediately.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Radiotherapy Information and Support Team 461206 or email:

Please read the information leaflet. Share the information it contains with your partner and family so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.

Radiographers These highly trained specialists are involved in your treatment from CT and throughout you radiotherapy. You will see where possible, the same team of radiographers each day you attend for your treatment. They are there to help you. If you have any problems or worries, please speak to them for any help and advice. You may also be referred to another member of the Oncology Team as necessary.

The centre is located in the Main Reception of the Queens Centre for Oncology and Haematology at Castle Hill Hospital. The opening times are Monday Friday 9:00am to 5:00pm

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Arrange For Someone To Take You Home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you dont have a responsible care partner to take you home, call one of the agencies below. Theyll send someone to go home with you. Theres a charge for this service, and youll need to provide transportation. Its OK to use a taxi or car service, but you still need a responsible care partner with you.

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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.

An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.

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What Are The Side Effects Of External Beam Radiotherapy

Like all treatments for prostate cancer, radiotherapy can cause side effects. These will affect each man differently, and you might not get all the possible side effects. Sometimes bowel, urinary and sexual problems after radiotherapy treatment are called pelvic radiation disease.

Side effects happen when the healthy tissue near the prostate is damaged by radiotherapy. Most healthy cells recover so side effects may only last a few weeks or months. But some side effects can start months or years after treatment. These can sometimes become long-term problems. Before you start treatment, talk to your doctor, nurse or radiographer about the side effects. Knowing what to expect can help you deal with them.

If you have hormone therapy as well as radiotherapy, you may also get side effects from the hormone therapy. Read more about the side effects of hormone therapy and how you can manage them.

If youre having radiotherapy as a second treatment, and you still have side effects from your first treatment, then radiotherapy can make those side effects worse or last longer. It may also cause other side effects. The most common side effects of radiotherapy are described here.

Short-term side effects of radiotherapy

Urinary problems

Radiotherapy can irritate the lining of the bladder and the urethra, which is the tube men urinate and ejaculate through. This can cause urinary problems, such as:

Bowel problems

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What Do I Need To Do To Get Ready For My Imrt Treatment

Getting ready for IMRT takes a great deal of planning. It can take two to three days for your radiation therapy team to plan your care. After giving you a physical exam and reviewing your medical history, your radiation oncologist will use different tools to plan your treatment. These tools will help your radiation oncologist decide the dose of radiation you need for your prostate cancer and how long your treatment will last.

Your radiation oncologist may send you to have one or more imaging tests to help plan where the radiation beams will be aimed. The imaging tests your radiation oncologist will use to plan your treatment may include:

• X-ray this test uses radiation to take a picture of the inside of your body. You may have seen a chest x-ray or x-ray pictures of your teeth or your bones.
• CT Scan is a type of x-ray that uses a computer to make pictures of your prostate cancer and the area around your prostate. You may be given contrast through an I.V. in your arm or to drink by mouth. Contrast will help your prostate cancer show up better during the CT Scan.
• MRI Scan is a test that uses a large magnet to make pictures of your prostate cancer and the area around your prostate.
• PET Scan is a test where you are given contrast before you have x-rays taken. The contrast will travel to the parts of your body where your prostate cancer is active. The x-ray will give your doctor a better picture of what your prostate cancer looks like.

Getting Ready For IMRT

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Urinary And Bowel Changes

Late side effects may be similar to the ones you had during treatment. Theres a very small chance you may develop other side effects. For example:

• The opening of your bladder may become narrower.
• You may have blood in your urine.
• You may have bleeding from your rectum.

These side effects are rare. They may come and go over time or be persistent and chronic. Your healthcare team will help you manage them.

Even if you dont develop any late side effects, remember that the tissues in your bladder and rectum were affected by your radiation therapy. Call your radiation oncologist if you:

• Have any new urinary, bladder, or bowel symptoms.
• Need to have a colonoscopy. Avoid having a colonoscopy for the first year after radiation therapy.
• Need any type of urological or rectal procedure.

Which Bowel Preparation Is Best Comparison Of Bowel Preparation And No Bowel Preparation In Prostate Cancer Patients Treated With Radical Radiotherapy To Assess The Effect Of Bowel Preparation On Prostate Shifts

There is strong evidence that, in patients treated without IGRT, rectal distension at a patients treatment planning scan can lead to geographical miss, which in turn reduces biochemical control and local control . Although there are other possible variables in prostate radiotherapy e.g. bladder filling, rectal distension is the single most important variable in causing prostate motion in the antero-posterior direction . There are several techniques to reduce rectal distention and consequent prostate shifts are in common use in the UK including a high fibre diet, laxatives and micro-enemas however there is paucity of randomized data confirming the best bowel preparation. Hence, this audit was performed to assess our current practice and to have standard departmental guidelines on best bowel preparation to minimize rectal distension.

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During Your Radiation Treatments

When its time for your treatment, your radiation therapists will bring you to the treatment room and help you onto the treatment table . Youll be positioned exactly how you were lying during your simulation. On the day of your first treatment, youll have some extra imaging scans to make sure youre positioned correctly. This is called a set-up procedure.

Youll also have special images called beam films taken during each of your treatment appointments. These are done to make sure your position and the area being treated are correct. They arent used to see how your tumor is responding to the treatment. The beam films help your radiation therapists make sure the radiation beams are correctly lined up with your prostate.

Your radiation therapists will do everything they can to make sure youre comfortable during your treatment. Once everything is ready, theyll leave the room and start your treatment.

Breathe normally during your treatment, but dont move. You wont see or feel the radiation, but you may hear the machine as it moves around you and is turned on and off. Your radiation therapists will be able to see you on a monitor and hear you through an intercom during your whole treatment. Tell them if youre uncomfortable or need help.

Youll be in the treatment room for 15 to 45 minutes, depending on your treatment plan. Most of this time will be spent putting you in the correct position. The actual treatment only takes a few minutes.

Figure 2. During your treatment

Management Of Bowel Dysfunction

Short of treating individual symptoms as needed, there are few, if any, treatment options for bowel dysfunction following radiation therapy. Laser therapy can stop rectal bleeding caused by radiation. Anti-diarrheal agents can help with loose bowel movements. Increasing fiber intake through whole grains, fruits and vegetables, or fiber supplements can also help.Avoiding foods that might irritate the gastrointestinal tract is important, but complete elimination of fibrous, bulky foods can lead to constipation and straining, which in turn can exacerbate rectal bleeding.

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Talk To Your Radiation Oncologist About Respiratory Gating

If you have left sided breast cancer, some radiation will likely make its way to your heart, and heart disease related to radiation for breast cancer is a significant concern. Radiation has been linked with a number of different forms of heart disease ranging from valve disease, to rhythm disturbances, to coronary artery disease.

Fortunately, the technique of respiratory gating or breath hold can reduce the amount of radiation that hits your heart significantly. With this technique, your technician will have you hold your breath for short periods of time during each session. It is important to ask about this before beginning your treatments, as special measurements will need to be taken to be sure that inhaling air into your lungs will move your heart away from the field of radiation.

Even though research has found benefit in these techniques, not everyone is informed of this option. Make sure to be your own advocate, so that you either receive this heart-sparing technique, or at least clearly understand why it may not be needed.

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Additional Eating And Drinking Tips For Radiation Therapy

• Chew your food slowly. Take your time eating each small meal.
• To make sure youre getting enough calories during radiation, ask yourself, What can I add to this meal to make it more calorie-rich? Think about topping your dishes with dressings and sauces. Or, think about adding extra ingredients you can add in or on top of your dishes.
• Cook foods that smell good
• Drink beverages that are high in calories, like hot chocolate and fruit juice
• Eat foods in a stress-free relaxing setting to make eating a positive experience
• Eat every few hours vs waiting until youre hungry

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Spaceoar For Prostate Radiation Therapy

Radiation therapy is a treatment option for prostate cancer. Radiation therapy can be very effective in treating prostate cancer. Some providers may suggest the use of SpaceOAR with treatment. The use of SpaceOAR can reduce radiation exposure to the rectum, and potentially reduce side effects from radiation therapy.

How Does External Beam Radiation Therapy Work

External beam radiation therapy, or EBRT, uses a machine to direct high-energy X-rays at the cancer in daily doses. The radiation beam is generated by a machine called a linear accelerator or LINAC. Using treatment planning computers and software, your treatment team controls the size and shape of the beam as well as how it is directed at your body to most effectively treat your tumor and minimize damage to surrounding normal tissue.

To minimize side effects, the treatments are typically given five days a week over a six-to-nine week period. The break in days allows the doctors to get enough radiation into the body to kill the cancer while giving healthy cells time to recover.

Watch our expert medical oncologist, Dr. Alicia Morgans from Vanderbilt-Ingram Cancer Center, discuss external beam radiation therapy:

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Diarrhea And Rectal Discomfort

Many people develop diarrhea within the first few weeks after treatment begins. Its also common to have cramping, pressure, and discomfort in your rectal area. You may also strain to have a bowel movement with no results.

There are some ways to help you manage these issues. Start following these guidelines if and when you begin to have symptoms. Continue them until your bowel movements return to your usual pattern. This may take 2 to 4 weeks after your treatment is completed.

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Swelling Bruising Or Tenderness Of The Scrotum

Symptoms generally resolve on their own within three to five days. Oral anti-inflammatory medications such as ibuprofen are usually sufficient for pain relief, if necessary. You should avoid hot tubs and Jacuzzis for at least two to three days after the procedure. Postpone bike riding until the tenderness is gone.

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Weekly Visits During Your Treatment

Your radiation oncologist and radiation nurse will see you each week to talk with you about any concerns, ask about any side effects you may be having, and answer your questions. This visit will be before or after your treatments each ________________. You should plan to be at your appointment for about 1 extra hour on those days.

If you need to speak with your radiation oncologist or radiation nurse any time between your weekly visits, call your radiation oncologists office or ask the support staff or your radiation therapists to contact them when you come in for treatment.

University Of Michigan Radiation Oncologist And Pcf

If you are about to undergo external-beam radiation for prostate cancer, you may find that the treatments themselves are easy. Preparing for the daily treatments, however, may take some getting used to but you can do it!

Here with some tips is University of Michigan radiation oncologist and Prostate Cancer Foundation -funded investigator, Daniel Spratt, M.D. The most important thing you can do, Spratt advises, is to familiarize yourself with the anatomy of the pelvis your doctor may have literature with an illustration that will help. If not, heres one that will give you a better understanding of where the prostate is, and the important anatomy nearby.

Seeing the big picture literally will help make it clear why your doctor is asking you to come to your treatments with a comfortably full bladder and an empty rectum, Spratt says. Having a full bladder is going to move the intestines upward and away from the radiation, and having a rectum about the same size every time the way we planned it before your treatment helps us be very precise, to make sure were giving all that dose to the prostate and not hitting the rectum, or that were avoiding the rectum but also missing some of the prostate. It allows us to use very tight margins, treating every bit of the cancer but not harming the normal tissue. Every program has a slightly different protocol, but the main thing is to keep things generally about the same every time.

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